Targeted chopstick mononostril approach for a lower clivus chordoma.

Chordomas are rare, aggressive tumors often located at the craniovertebral junction. Endoscopic approaches are increasingly used for their treatment. We present a case of a patient with a chordoma at the craniovertebral junction treated through a mononostril endoscopic approach, enabling total resection with minimal nasal morbidity. The technique minimized nasal structure manipulation and avoided complications such as cerebrospinal fluid leaks. The nasopharyngeal mucosa was carefully sutured at the end of the procedure, further reducing postoperative nasal morbidity. The endoscopic "chopstick" approach, with mucosal suturing, offers reduced nasal morbidity and favorable recovery in craniovertebral junction chordomas.